Upper GI Pathologies Flashcards
two types of oesophageal cancer
squamous and adeno
which type of oesophageal cancer are smoking, alcohol and dietary carcinogens risk factors for
squamous carcinoma
what is Barrett’s oesophagus
a metaplasia whereby the squamous epithelium of th eosophagus is replaced by glandular epithelium as a result of oesophageal reflux
more common hiatus hernia cause of oesophageal reflux
sliding hiatus hernia
5 pathologies of upper GI tract
oesophageal reflux oesophageal cancer gastritis peptic ulcetration gastric cancer
what is a hiatus hernia
where part of the stomach moves up into the thorax (i.e. past diaphragm)
two types of hiatus herbia
sliding and para-eosophageal
most common type of hiatus hernia
sliding
which parts of the stomach herniate in sliding
cardiac region and fundus
which parts of the stomach herniate in para-oesophageal
the fundus
why is reflux more common in sliding than in para-oesophageal
because the mechanism of sliding means that the LOS is as contracted and the stomach contents can freely escape upwards
two main complications of hiatus hernia related reflux
fibrotic healing forming strictures
barrett’s oesophagus
what is the relatinoship between barrett’s and oesophageal cancer
barrett’s is a precursor to cancer
which type of oesophageal cancer, squamous or adenocarcinoma, is most likely to occur from barrett’s oesophagus
adenocarcinoma (barrett’s is metaplasia of glandular epithelium
what is the 3rd most common alimentary cancer
oesophageal cancer
red flag symptoms of oesophageal cancer
dysphagia, vomiting, weight loss and symptoms of GI blood loss like haematemesis or dizziness
where does oesophageal cancer most commonly metastasise to
liver
5 non red flag symptoms of oesophageal cancer
painful swallowing, hoarseness, retrosternal pain, uncontrollable hiccups and lympadenopathy
oesophageal cancer has a good/poor prognosis
poor - 5 year is <15%
what is gastritis
inflammation of stomach lining
what can gastritis lead to
stomach ulcer
what vitamin deficiency arises from autoimmune gastritis
b12, pernicious anaemia
the 3 types of gastritis
autoimmune, bacterial and chemical injury
pathophysiology of gastritis
disruption of mucus later/acid production –> stomach lining exposed to acid –> damage
common drug that causes gastritis
NSAIDs
where could bile reflux from to cause chemical gastritis
the duodenum
3 causes of chemical gastritis
drugs, alcohol and bile reflux
in autoimmune gastritis what are the antibodies targeted against
parietal cells and intrinsic factor
most common type of gastritis
bacterial
most common cause of bacterial gastritis
H. Pylori
H. Pylori is gram negative/positive
negative
pathophysiology of a gastric ulcer
commonly H. Pylori caused gastritis –> ulcer forms
2 main causes of gastric ulcers
H. Pylori and NSAIDs (aspirin ibruprofen)
Presentation of a gastric ulcer
epigastric pain nausea and vomiting weight loss (less nutrition) haematemesis (if bleeding ulcer) anaemia
peritoneal complication of a gastric ulcer
peritonitis when the the ulcer perforates
chronic complication of ulcer bleeding
anaemia
2nd most common alimentary cancer
gastric
histological types of gastric cancer
adenocarcinoma
what infection is gastric cancer associated with
H. Pylori
ways in which gastric cancer may spread
directly to surrounding structures, lymphatically, through blood and transcoelomically (in peritoneal cavity)
stomach is retro/intra peritoneal
intraperitoneal
presentation of gastric cancer
dyspepsia dysphagia early satiety weight loss nausea and vomiting anaemia
how does gastric cancer present in 70% of cases
with dyspepsia and no more
why should you refer all cases of dyspepsia for an endoscopy
because 70% of gastric cancer presents with just dyspepsia
gastric cancer has a good/poor prognosis
poor - 5 year <20%
type of epithelium in stomach
simple columnar
type of epithelium in oesophagus
stratified squamous
